Parkinson’s Misdiagnosis: Huntington’s Disease
Huntingtons disease causes brain cells to break down. Symptoms can include clumsiness, insomnia, lack of energy, and lack of physical control. Difficulty walking often comes with Huntingtons, which is why it could be a reasonable diagnosis for someone with Parkinsons.
My husband has now passed, but was misdiagnosed with Huntingtons disease.
Wait So What Is Parkinsonism
Parkinsonism refers to the motor symptoms that are typically associated with PD, such as tremors, stiffness, and walking/balance problems. Both PD and LBD are forms of Parkinsonism, meaning that PD patients and LBD patients may experience these motor symptoms.2 Because the Parkinsonism motor symptoms of PD and LBD can be very similar, it can be difficult to differentiate between the two conditions.
There Is Only One Cause For A B12 Deficiency Auto
After a B12 deficiency is diagnosed, several tests can be done to try to find the cause of the deficiency. Often nothing is tested at all, because it is believed that a cause often cant be found. Only in 34% of cases people are tested for causes according to our survey. But whén the tests are done a cause is found in 50% of the cases.
Often only one test is done: antibodies against the intrinsic factor. When they are not found it is often, falsly, concluded there is no pernicious anemia, or even, there is no deficiency at all. But this test is negative in 30 to 50% of the patients wíth pernicious anaemia. Besides that, there are many more causes for a deficiency, many of them not well known. Some causes, like parasites, can be treated so vitamin absorption can be restored.
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Diagnosis: Parkinsons Dementia Or Dementia With Lewy Bodies
During assessment, a specialist may look at when the dementia symptoms first appeared before reaching a diagnosis of Parkinsons dementia or dementia with Lewy bodies.
If there have been motor symptoms for at least one year before dementia symptoms occur, specialists will often give a diagnosis of Parkinsons dementia.
If dementia symptoms occur before or at the same time as motor symptoms, specialists will usually give a diagnosis of dementia with Lewy bodies.
However, it should be noted that in some cases of dementia with Lewy bodies, no motor symptoms develop at all.
Theres no single test diagnosis is made through several different assessments, usually starting with an appointment with your GP or Parkinsons nurse.
Some people find it helps to go to the appointment with someone who knows them well, who can give the GP or Parkinsons nurse information about changes theyve noticed.
Your GP can discuss your symptoms with you and carry out a physical examination, including blood and urine tests, to rule out other potential causes of the symptoms .
Your GP may also review your medication, in case your symptoms are side effects.
If your GP thinks you have dementia, they can refer you to a specialist, such as a neurologist, psychiatrist or geriatrician.
You might be referred to a memory clinic or memory service. In some areas of the country, you can refer yourself to these services.
But if you feel you need to see the specialist again, you can ask to be referred back.
Robin Williams Would Have Been 70 This Year Heres What We Know About Lewy Body Dementia Suicide And Parkinsons
On July 21, actor and comedic genius Robin Williams would have turned 70. Williams not only amplified and brought awareness to the life-changing, prevalent disease known as Lewy Body Dementia, but his passing brought much needed attention to the importance of mental health and the non-movement symptoms of depression and anxiety that can accompany a neurodegenerative disease.
Nearly seven years after his passing, what do we know about Lewy Body Dementia? How can we help people with a neurological disease experiencing suicidal thoughts?
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What Is The Link Between Parkinsons And Lewy Body Dementia
Being Patient: Are Parkinsons disease and Lewy body dementia related?
Dag Aarsland: Yes, theyre related in terms of symptoms and the brain changes. Many scientists consider Parkinsons and Lewy body dementia as a continuum of disease rather than two separate diseases. But there are very active and lively discussions about that. There are arguments for separating and combining them, but there are many similarities.
Being Patient: Do you group Lewy body dementia with Parkinsons disease in your research?
Dag Aarsland:From a research point-of-view, we try to separate them. We identify the specifics and categorize patients in different groups and study them carefully in order to see how they relate. In clinical practice, its different. I also see patients with Parkinsons and unfortunately, many of them develop dementia and hallucinations or memory problems. In clinical practice, its very much the same challenges for patients, carers and the doctor in terms of findings and the right therapy.
Differences Between Pdd And Dlb
So, how are PDD and DLB different from each other? That depends on whom you ask. Some clinicians feel that these two conditions are simply different versions of the same disorder. In fact, some professionals use the terms interchangeably. Yet, according to currently agreed-upon diagnostic guidelines, there are some differences.
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Hyperkinetic Movement Disorders Due To Parasitic And Fungal Infections
Parasitic infections located in the basal ganglia and thalamus may induce contralateral limb ballism, choreoathetosis, and dystonia. Hemichoreahemiballismus is the most frequent movement disorder in patients with cerebral toxoplasmosis, which is mainly observed in immunocompromised patients . It remains rare, occurring in < 10% of cerebral toxoplasmosis cases . Cerebral fungal infection should be considered in immunodeficient patients presenting with abnormal hyperkinetic movements. Hemichorea-hemiballismus and choreoathetosis have been reported to be associated with cryptococcosis , or cerebral histoplasmosis in HIV infected patients. Cases of hemidystonia or chorea were described in association with cysticercosis cysts or calcifications in the thalamus or putamen. Cysticercosis lesions are more often located in the cortex, where they may be responsible for postural and kinetic tremor of the upper limb, associated with epilepsy in 1/3 of cases . Of note, cortical lesions of cysticercosis can result in epilepsia partialis continuum, which can be misidentified as a hyperkinetic movement disorder. Anthelmintic therapy often results in full recovery of patients with movement disorders secondary to cysticercosis .
Blood Sugar And Electrolyte Disturbances
Diabetic striatopathy is defined as a hyperglycemic condition associated with either one or both of: chorea/ballism striatal hyperdensity on CT or hyperintensity on T1-weighted MRI of the basal ganglia . Hemichorea or hemiballism typically develops following severe non-ketotic hyperglycaemia in the context of long-standing poor control of type 2 diabetes mellitus . Ketosis is not associated in most cases . It is more common in females. Most patients have hemichorea, but bilateral involvement is found in 10% of patients. Although choreic movements often dissipate within hours of hyperglycaemia correction, hemiballism may persist for over 3 months in 20% of patients. Delayed onset after achieving normoglycaemia, persistent severe movements or late recurrences are rarely observed. There may be T1-weighted MRI hyperintensities or hyperdensity on CT in the contralateral basal ganglia . Diabetic striatopathy differs from hypertensive hemorrhage by the absence of mass effect and the sparing of the internal capsule. Management involves treating the underlying cause, while protecting the limbs from injury. If severe or prolonged, symptoms can be alleviated by antipsychotics, dopamine-depleting agents, gamma aminobutyric acid -receptor agonists, and selective serotonin reuptake inhibitors. Deep-brain stimulation of the globus pallidus or thalamus may be considered in refractory cases . There are some evidence of hemorrhage as a possible pathogenic factor .
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Signs Of Vitamin B12 Deficiency
The symptoms of vitamin B12 deficiency arise mostly due to the lack of healthy blood cells that are required for transporting oxygen to all your body cells.
This lack of B12 can lead to many physical and psychological problems. Though fatigue and weakness are the most common symptoms, there are many other sneaky symptoms to watch out for.
Impaired Absorption Can Results In Lack Of Vitamin B12
Malabsorption could be one reason for showing signs of a vitamin B12 deficiency even if you include meat in your diet.
Inadequate B12 absorption can occur for a number of reasons. For example, low vitamin B12 levels are sometimes seen in persons who have had gastric bypass surgery. Also, digestive problems that are caused by intestinal diseases such as celiac disease, Crohns disease, or intestinal bacterial overgrowth can also affect vitamin B12 absorption.
Having a tapeworm infection in your body can cause many symptoms, including having a lack of B12. A tapeworm infection will also make it more difficult to recover from a B12 deficiency.
Also certain prescription drugs can affect your ability to absorb vitamin B12, including anti-ulcer drugs, antacids and Metformin a drug taken by diabetic patients.
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Conditions Mistaken For Multiple Sclerosis
Did you know that as many as 1 in 5 people with other neurological conditions are misdiagnosed with Multiple Sclerosis ? This comes from a study published in the May 2019 journal of Multiple Sclerosis and Related Disorders. Certain medical conditions are harder to diagnose than others, especially when they have various mimicker diseases that can cause similar or identical symptoms. In this blog post, we will review MS symptoms, how MS is diagnosed, and some common mimicker diseases that can cause similar or identical symptoms.
Diagnosis Of B12 Deficiency
If you have symptoms that suggest you may have a deficiency of B12, your healthcare provider can confirm this suspicion simply by checking the levels of the vitamin in a sample of your blood.
If your vitamin B12 levels are on the low side of normal, your healthcare provider may order two more blood tests: homocysteine and methylmalonic acid. These metabolic substances are both elevated in vitamin B12 deficiency.
Although this is the most typical way to diagnose B12 deficiency, other tests may be used, including magnetic resonance imaging of the spinal cord , or somatosensory or visual evoked potentials.
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How Long It Takes To Correct Vitamin B12 Deficiency
Bringing levels of vitamin B12 to be within the normal range of between 200 and 900 ng/mL depends on the severity of your B12 deficiency.
To help recover from a vitamin B12 deficiency, doctors will recommend a course of treatment involving oral supplementation or injections.
The journal Blood reports that it should take up to a week for vitamin B12 levels to rise. It is usually possible to completely correct a vitamin B12 deficiency within 6 weeks to 3 months.
However, with the proper B12 supplements, you can start to fix a vitamin B12 deficiency fairly quickly. The journal Annals of Surgery reports that B12 levels start to quickly rise after taking B12 supplements.
The Use Of Levodopa And Peripheral Neuropathy
There are reports in the literature that levodopa use may increase the risk of peripheral neuropathy, although other studies suggest that this is not the case. There are studies that demonstrate for example, that cumulative Levodopa exposure correlates to prevalence of PN in people with PD. Other studies however, demonstrate no difference in the prevalence of PN whether the person was treated with Levodopa or not, suggesting that Levodopa treatment does not play a role in development of PN.
Another area of research that emerges from the literature is the potential role of Vitamin B12 deficiency in the development of PN in those with PD. Some studies suggest that Vitamin B12 deficiency is a more common cause of PN among those with PD than those with PN who do not have PD.
There is also research that suggests that levodopa treatment may contribute to PN through impairment of Vitamin B12 metabolism, leading to Vitamin B12 deficiency. Taking COMT inhibitors such as Entacapone may protect against this complication.
Regardless, if PN is diagnosed in anyone, whether they have PD or not, and whether they take Levodopa or not, Vitamin B12 and various other markers of Vitamin B12 metabolism should be tested. If Vitamin B12 levels are low or even low-normal, a person should take Vitamin B12 supplementation, which may help with the symptoms of PN. Other causes of PN, many of which can be checked with various blood tests, should be investigated as well.
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Parkinson’s Misdiagnosis: Thyroid Issues
Thyroid issues affect muscle strength and can cause fatigue, muscle aches, stiffness, and joint pain. The early stages of Parkinsons could look similar to thyroid problems. However, with time and as a patient learns more about his or her own symptoms, they are able to provide a fuller picture, which can lead to a clearer diagnosis.
My husbands endocrinologist adjusted his thyroid medicine and was so surprised when he did not feel any better.
Parkinsons And Lewy Body Disease
Lewy body disease occurs when there is an abnormal build up of a protein called alphasynuclein in the brain. Depending on where the proteins accumulate, Lewy body disease can lead to impairments in movement, thinking and behaviour.
Lewy body disease includes three overlapping disorders:
- Dementia with Lewy bodies
- Parkinsons disease dementia
This overlap results in the disease being called a spectrum disease.
In people with Parkinsons a large number of Lewy bodies appear in an area of the brain known as the substantia nigra. This area of the brain is responsible for movement, so the Lewy bodies are likely to cause impairments in movement.
Some people may go on to develop dementia with Lewy bodies. In this form of the disease, the clumps of protein occur in the cortex . This part of the brain is responsible for many cognitive processes, so the Lewy bodies are likely to result in cognitive impairments like those described under the heading above. It can result in symptoms similar to those seen in Alzheimers.
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Coping With Cognitive Impairment In People With Parkinsons Disease And Their Carers: A Qualitative Study
Rachael A. Lawson
1Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK
2Department of Nursing, Midwifery and Health, Northumbria University, Newcastle upon Tyne, UK
Cognitive impairment in Parkinsons disease is a common nonmotor symptom, with up to 80% of people with PD developing dementia . Previous quantitative studies have shown that cognitive impairment can be detrimental to the quality of life of people with PD and their informal caregivers . However, these studies could not explain the mechanism or what aspects of cognitive impairment affected people with PD and their carers. In-depth qualitative studies may be more suitable to address these questions.
This exploratory study used a qualitative design as part of a mixed-methods study. A partially mixed concurrent equal status design was used, where quantitative and qualitative data were collected in parallel to address the same overarching aims and hypotheses . The rational for this approach is that this design is complementary and seeks to gain a deeper, richer, and more complete understanding of a phenomenon by utilising the different methods to investigate either overlapping phenomena or different aspects of a single phenomenon . This paper draws on the findings from the qualitative component of the study.
2.2. Data Collection and Analysis
How Common Is B12 Deficiency
B12 deficiency is a relatively common health issue which varies by age group. Some countries and continents such as Latin America, Africa, and India also experience higher rates of deficiency than others.
- According to the
, vitamin B12 deficiency can be broken down into three main categories:
- autoimmune issues
- dietary insufficiency
A protein called intrinsic factor made in the stomach allows our bodies to absorb vitamin B12. Interference with the production of this protein can cause deficiency.
Malabsorption may be caused by certain autoimmune conditions. It can also be affected by weight loss surgeries that remove or bypass the end of the small intestine, where the vitamin is absorbed.
Theres evidence to suggest people can be genetically predisposed for a B12 deficiency. A 2018 report in The Journal of Nutrition explains that certain gene mutations or anomalies can affect all aspects of B12 absorption, transport, and metabolism.
Being a strict vegetarian or vegan may cause a vitamin B12 deficiency. Plants dont make B12 its found mostly in animal products. If you dont take a vitamin supplement or eat fortified grains, you may not be getting enough B12.
People at risk of vitamin B12 deficiency can include those with:
- a family history of B12 anemia
- strict vegetarian or vegan diets
- all or part of the stomach removed
- advanced age
- congenital disorders
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Foster A Good Relationship
Lastly, maintaining your relationship and communication with the person with Parkinsonâs can be the most challenging and rewarding aspect of caregiving. As Parkinsonâs disease progresses, the roles change and the person with Parkinsonâs may go from being an independent head of the household to a very dependent person requiring a significant level of care. However, research shows that despite high levels of strain, caregivers with good quality relationships have reduced depression and better physical health. Remember, as a caregiver your service to your loved one is beyond measure in terms of love, depth of care, and concern.
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Signs And Symptoms Of Vitamin B12 Deficiency
Dr. Rashmi ByakodiMay 20, 2020In This Article
Vitamin B12 is a vital nutrient that is required for the production of oxygen-carrying red blood cells in our body.
It is necessary for DNA synthesis and for the proper functioning of the nervous system.
Vitamin B12 has innumerable other functions from maintaining the health of skin and hair to improving memory and cognition.
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A B12 Deficiency Is Rare And Only Occurs In Older People
A B12 deficiency is not rare at all it is quite common. Several studies through the years showed that between 3 and 5% of the population has a B12 deficiency. One article in the Dutch Medical Journal even said 5 to 10% based on a serum B12 of 148 pmol/L).A deficiency does occur more in older people than in the young, but the prevalence is high in all ages.A deficiency in children is even more unknown, not looked for and not taken seriously.1 in 200 children under 19 have a clear deficiency.Furthermore test results for children are interpreted as if they were adults, when research has shown that B12 is supposed to be higher and MMA and homocysteine lower. Homocysteine at least, has age-related reference values in some hospitals.